中国妇幼健康研究2026，Vol.37Issue(4)：76-80,5.DOI:10.3969/j.issn.1673-5293.2026.04.011
儿童大叶性肺炎的临床特征及进展为重症大叶性肺炎的危险因素
Clinical features of lobar pneumonia in children and risk factors for progressing to severe lobar pneumonia
摘要
Abstract
Objective To systematically analyze clinical features and laboratory indexes of children with lobar pneumonia,and to further provide diagnostic clues for severe cases.Methods Clinical data of 449 children diagnosed as lobar pneumonia in Department of Pediatrics,The First Affiliated Hospital of Xi'an Jiaotong University from May 2023 to June 2025 were collected and 337 children were included in study according to inclusion and exclusion criteria.Severity of the disease was evaluated according to Guideline for Diagnosis and Treatment of Community-Acquired Pneumonia in Children(2019 Version),and the children were divided into two groups:mild lobar pneumonia group and severe lobar pneumonia group.Demographic characteristics,distribution of pulmonary consolidation sites on chest imaging film,etiology and laboratory indexes were analyzed and compared between the two groups.Receiver operating characteristic(ROC)curve and area under curve(AUC)were used to determine clinical diagnostic values of those laboratory indexes with statistical differences for severe lobar pneumonia.Results In this study,58.8%of lobar pneumonia cases occurred in school-age children,and 65.6%of children were infected with Mycoplasma pneumoniae.On chest imaging film,consolidation site of 55.5%of the lobar pneumonia cases was located in the right lung,and there was a statistical difference between the two groups(χ2=6.877,P<0.05).In laboratory indexes,neutrophil count(NEU),levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),D-dimer(D-D),fibrinogen(FIB)and lactate dehydrogenase(LDH)of the children with severe lobar pneumonia were higher than those of the children with mild lobar pneumonia,there were statistical significance between the two groups(Z=-5.934--2.088,all P<0.05).Analysis of diagnostic values of these laboratory indexes with statistical differences showed that their AUCs were all>0.5,indicating that these increased laboratory indexes were risk factors for mild lobar pneumonia progressing to severe lobar pneumonia.Conclusion Susceptible age of lobar pneumonia is school-age of children,and Mycoplasma pneumoniae is the main pathogen.And consolidation site on chest imaging film in lobar pneumonia is mostly in the right lung.Such laboratory indexes as NEU,CRP,PCT,IL-6,D-D,FIB and LDH could be regarded as markers for early identification of severe lobar pneumonia.关键词
儿童/大叶性肺炎/实验室指标/临床特征Key words
children/lobar pneumonia/laboratory index/clinical feature分类
医药卫生引用本文复制引用
王晓晴,张艳敏,高文娟,刘蓉菲,张欣敏,史瑞明..儿童大叶性肺炎的临床特征及进展为重症大叶性肺炎的危险因素[J].中国妇幼健康研究,2026,37(4):76-80,5.基金项目
国家自然科学基金(82211530115) （82211530115）
陕西省重点研发项目(2020SF001) （2020SF001）
